Studies of catatonia

Abstract

1. Observational and photographically recorded data showed that cerea flexibilitas, which was present quite markedly in two stuporous catatonic dementia praecox patients, disappeared with the onset of sleep. The motility of these two patients, which was very low during the waking state, became much greater during sleep, approaching, although not reaching, the range to be expected from normal sleepers. 2. Three other patients observed at Kings Park State Hospital, who exhibited the waxy state during waking hours, showed similar relaxation during sleep. 3. Eight non-cataleptic dementia praecox patients showed no marked change between the waking and the sleep state in similar records of motility. Their sleeping motility was quite comparable to that of the healthy normal individual. 4. Our results indicate that studies of experimental catalepsy which attempt to explain the waxy state in dementia praecox patients must provide a “functional” mechanism so that the quick reversibility obtained at the onset or end of sleep, is accounted for. 5. On the basis of present knowledge, it seems safe to say that activity of either cortical or lower brain centers must be directly or indirectly responsible for the occurrence of cerea flexibilitas in stuporous catatonic dementia praecox patients. Future studies of experimental catalepsy in animals might well include a determination of the effect on the experimental catalepsy of the stimulation of sleep centers. If the elimination of the catalepsy by such stimulation occurred, it would be a criterion for the identification of the experimentally produced catalepsy with that occurring in the stuporous dementia praecox cases.